Effect of low-dose colchicine in patients with type 2 diabetes and recent myocardial infarction, Docvidya, Medshorts, Diabetes, General Practitioner, General Practice, Consultant Physician, Diabetologist, Cardiologist, Cardiology, Type 2 diabetes, Myocardial infarction, Colchicine, Coronary revascularization, Cardiovascular (CV) death, Resuscitated Cardiac arrest stroke,

Effect of low-dose colchicine in patients with type 2 diabetes and recent myocardial infarction

A recent study found that among patients with type 2 diabetes and a recent myocardial infarction, the daily intake of 0.5 mg of colchicine has been shown to greatly reduce the occurrence of cardiovascular events. This study’s findings were published in the journal, Diabetes care. 
The COLCOT study was a randomized, double-blind trial that included 959 patients with type 2 diabetes, and they were monitored for a median duration of 22.6 months. Patients were randomly assigned to receive either colchicine (n=462) at a daily dose of 0.5 mg or a placebo (n=497) initiated within 30 days of suffering a myocardial infarction. The primary endpoint of the study included composite of cardiovascular (CV) death, myocardial infarction, resuscitated cardiac arrest stroke, or urgent hospitalization for angina necessitating coronary revascularization.
The incidence of a primary end point event was 8.7% among patients in the colchicine group, whereas it was 13.1% in the placebo group (hazard ratio 0.65; 95% CI 0.44-0.96; P = 0.03). Nausea was reported in 2.7% and 0.8% in the study groups, while pneumonia occurred in 2.4% and 0.4% in the colchicine and placebo groups, respectively.
The above results demonstrate that in individuals diagnosed with type 2 diabetes (T2D) who have experienced a recent myocardial infarction, the administration of a daily dose of 0.5 mg colchicine results in a significant decrease in the occurrence of cardiovascular events.
 

B-Gn-F plane proves as the most accurate best mandibular midsagittal plane to segment and identify mandible anatomical landmarks, Medshorts, Docvidya, Dental, Dentist, Dental & Oral Health, Mandibular midline, Mandibular Midsagittal Plane (MMSP), Cone-Beam Computed Tomography (CBCT), B-Gn-F, B (supramentale), Gn (gnathion), and F (mandibular foramen).

B-Gn-F plane proves as the most accurate best mandibular midsagittal plane to segment and identify mandible anatomical landmarks

According to a recent study, deep learning can segment and identify mandibular midline landmarks with the help of the best mandibular midsagittal plane (MMSP), which is B-Gn-F. This study was published in the European Journal of Medical Research.

This study included 400 participants who were randomly assigned into a training group (n=360) and a validation group (n=40), along with a test group (n=50) comprising normal individuals. PoseNet identified 27 anatomic landmarks from the mandible images from cone-beam computed tomography (CBCT) using the PointRend deep learning mechanism. For the test group, three-dimensional (3D) coordinates were obtained for five central landmarks and two pairs of side landmarks. Using the template mapping technique, every 35 combinations of 3 midline landmarks were screened. For each of the 35 mirror planes, the asymmetry index (AI) was calculated. The top 4 planes having the smallest AIs were compared through volume difference, similarity index, and distance in order to find the plane with the least errors.

At the end of the study, it was found that in 10 ± 1.5 seconds, the mandible was automatically segmented with a 0.98 Dice similarity coefficient. Among the 27 landmarks, the average localization error was 1.04 ± 0.28 mm. The plane created by B (supramentale), Gn (gnathion), and F (mandibular foramen) should be used by MMSP. The average AI grade observed was 1.6. No significant difference was seen in volume or distance, although the similarity index was significantly different.

From the above results, it can be concluded that deep learning may segment and identify mandibular midline landmarks with the help of the best mandibular midsagittal plane (MMSP), which is B-Gn-F.

The impact of C-reactive protein on the efficacy of roxadustat in managing anemia in chronic kidney disease, Medshorts, Docvidya, Anemia, C-reactive protein, Chronic kidney disease (CKD), Roxadustat, Blood C-reactive protein (CRP)

The impact of C-reactive protein on the efficacy of roxadustat in managing anemia in chronic kidney disease

A recent study demonstrated that roxadustat displays similar efficacy across different blood C-reactive protein (CRP) levels. Additionally, in the CRP ≥ upper limit of normal (ULN) group, roxadustat can uphold efficacy comparable to erythropoiesis-stimulating agents (ESA) without the need for dose escalation. The study's results were recorded in the publication BMC Nephrology. 
A comprehensive search was conducted across electronic databases, including Web of Science, Pubmed, Embase, Cochrane Library, Wanfang, International Clinical Trials Registry Platform (ICTRP), and CNKI from their inception until 19thMay, 2022. A systematic review was performed on evidence from randomized controlled trials that used hypoxia-inducible factor-prolyl hydroxylase inhibitors (HIF-PHIs) for treating renal anemia. The meta-analysis findings were derived from the mean difference (MD) in changes in hemoglobin concentration (∆Hb) pre- and post-treatment, utilizing a random-effects model. Groups with CRP levels at or above the upper limit of normal (ULN) were compared with those below the ULN. Further analysis was conducted within the CRP ≥ ULN group, comparing erythropoiesis-stimulating agents (ESA) and HIF-PHIs.
This analysis included a total of seven studies from six publications. When comparing the CRP ≥ ULN group with the CRP < ULN group, 524 patients from four studies were analyzed. All patients were administered roxadustat as the primary intervention. The pooled results showed no significant difference in ΔHb between patients with CRP ≥ ULN and CRP < ULN at baseline (MD: 0.00, 95% CI: -0.32 to 0.33, P value= 0.99). The effectiveness of roxadustat and erythropoiesis-stimulating agents was compared in three studies involving 1399 patients within the CRP ≥ ULN group. The findings revealed no significant difference in ΔHb between patients treated with ESAs and HIF-PHIs (MD: 0.24, 95% CI: -0.08 to 0.56, P value = 0.14). Regarding medication dosage, an increase in ESA dose over time was observed in various studies, particularly noticeable in the CRP ≥ ULN group, while the roxadustat dose remained constant over time and was not affected by the baseline CRP levels.
Therefore, roxadustat exhibited similar efficacy regardless of the CRP levels. Additionally, in the CRP ≥ ULN group, roxadustat can sustain effectiveness comparable to erythropoiesis-stimulating agents without the necessity for dose escalation.
 

Recent medical technologies in the management of cough,cough,Eladis, Placebo, Acute respiratory viral infections, Cough

Recent medical technologies in the management of cough

Recent research indicated that Eladis® exhibited overall effectiveness and a statistically significant superiority compared to the placebo. The data from this study were presented in the journal Terapevticheskii arkhiv.

This phase III clinical trial enrolled 250 individuals aged 18 to 65 years suffering from acute respiratory viral infections with acute bronchitis or upper respiratory tract involvement. Participants were randomly assigned into two groups of 125: one group received Eladis® (40 mg tablets), while the other group received a placebo. The study drugs were administered as one tablet twice daily for a duration of seven to fourteen days. Following the treatment, patients were followed up (on day 7±2) to evaluate the therapy effects on the frequency and intensity of daytime and nighttime cough, the frequency of coughing episodes, the severity of cough, the duration until clinical resolution of cough, and the effect on the severity of the main symptoms associated with acute respiratory viral infections.

Significant differences were observed among the study groups in the percentage of patients who achieved a reduction in coughing attack frequency by 50% or more by day five (p value <0.0001). Additionally, the Eladis® group demonstrated clinical resolution of cough two days earlier, with a median time of six days compared to eight days in the placebo group. By day five of treatment, there was a substantial decrease in both the frequency and severity of cough attacks, exceeding 3.5 points. All these effects were correlated with the drug's high safety profile.

Therefore, Eladis® demonstrated overall efficacy and a statistically significant benefit in comparison to the placebo.

Benign prostatic hyperplasia (BPH), Catheterization, Acute urine retention, Silodosin, Treatment outcome,urology,urologist,LUTS due to BPH,Correlation between the duration of catheterization and the outcome of a trial for patients with acute urine retention due to BPH,catheterization

Correlation between the duration of catheterization and the outcome of a trial for patients with acute urine retention due to BPH

A new study demonstrated that patients who have been catheterized due to acute urinary retention secondary to benign prostatic hyperplasia (AUR Secondary to BPH) may experience spontaneous voiding after catheter removal if they are treated with silodosin, regardless of the duration of catheterization. However, side effects tend to increase with longer periods of catheterization. This study’s findings were published in the journal, Urologia.

The study included 260 patients who experienced acute urinary retention secondary to benign prostatic hyperplasia. The patients underwent catheterization and were subsequently allocated at random to receive either 8 mg of silodosin for a period of three days or seven days. After the treatment period, the catheter was removed, and the success of voiding unaided was evaluated.

Out of the 260 men who were treated, 74 men who were on a 3-day silodosin regimen and 88 patients who were on a 7-day silodosin regimen did not require re-catheterization on the day of outcome of trial without catheter (TWOC) (57% and 68% respectively). In the group of participants who underwent the 3-day silodosin regimen, 16.2% experienced complications like acute urinary tract infection, urinary leakage, hematuria, or catheter blockage. On the other hand, in the group that received the 7-day silodosin treatment, 48.5% reported similar issues.

Therefore, silodosin treatment demonstrated positive outcomes in patients who have undergone catheterization as a result of AUR secondary to BPH. Irrespective of the duration of catheterization, these patients can spontaneously void after the removal of the catheter if they are treated with silodosin. It is important to consider that the likelihood of experiencing side effects tends to increase with longer periods of catheterization.

The effectiveness of adjuvant sublingual immunotherapy following septomeatoplasty, Docvidya, Medshorts, Allergic Rhinitis, Sublingual immunotherapy (SLIT), Septomeatoplasty (SMP) Allergic rhinitis(AR), Septal deviation, Dust mites

The effectiveness of adjuvant sublingual immunotherapy following septomeatoplasty

A recent study showed that sublingual immunotherapy (SLIT) has the potential to be an optimal  adjuvant therapy post-septomeatoplasty (SMP) for individuals suffering from allergic rhinitis (AR). This study’s findings were published in The Laryngoscope.

This study included 96 patients diagnosed with allergic rhinitis caused by dust mites, in addition to concurrent septal deviation and hypertrophy of the inferior turbinate. All patients underwent surgical intervention (SMP). Subsequently, the patients were divided into two groups: the control group (n=44), who underwent surgery alone, and the SMP+SLIT group (n=52), who were given SLIT as an adjuvant therapy. The results of the rhinitis control assessment test (RCAT) and the demographic data were analyzed.

No significant differences were noted in any of the variables between the two groups before and 1^st month after surgery. However, at the 3^rd and 6^th  month assessments, the SMP + SLIT group demonstrated a significant enhancement in the total RCAT scores in comparison to the SMP only group (28.6 ± 1.56 versus 24.5 ± 3.66, p < 0.001, 27.1 ± 2.87 versus 19.9 ± 5.56, p < 0.001). Additionally, superior control of all RCAT sub-categories was noted in the SMP + SLIT group during the 3^rd  and 6^th month evaluations.

In conclusion, SLIT could potentially function as a beneficial adjuvant treatment following SMP for individuals suffering from AR.

Evaluation and comparison of the effectiveness of low-level laser therapy and low-intensity pulsed ultrasound in reducing orthodontic pain, Dental, Docvidya, Medshorts, orthodontic pain, low-level laser therapy (LLLT), low-intensity pulsed ultrasound (LIPUS), 810-nm aluminum-gallium-arsenide (AlGaAs) diode laser, Visual Analog Scale (VAS 100 mm).

Evaluation and comparison of the effectiveness of low-level laser therapy and low-intensity pulsed ultrasound in reducing orthodontic pain

According to a recent study, low-level laser therapy (LLLT) and low-intensity pulsed ultrasound (LIPUS) effectively reduced separation pain when applied in multiple doses during orthodontic treatment. The results of this study were published in the journal, BMC Oral Health.

150 patients were randomly assigned to three groups in this single-blind, randomized controlled trial: the LLLT group, the LIPUS group, and the control group. The first dose of the laser or ultrasound was applied 5 min from the separators' placement, second dose was given after 24 h, and the last dose was administered on both maxillary and mandibular first molars after 48 h. The patients were exposed to the laser for 20 s, using an 810-nm aluminum-gallium-arsenide (AlGaAs) diode laser on continuous mode. For 20 minutes, 1.6 MHz ultrasonic toothbrush treatment was applied (5 minutes for each first molar). The control group was administered the separator without any other intervention. Pain intensity was assessed at several time intervals during the first four days post the separator’s placement, using a Visual Analog Scale (VAS 100 mm).

It was found after assessing 145 patients that a significant difference in pain perception was observed among the three groups after 5 min. Pain level reached its maximum intensity after 24 h. All the assessment time points showed a statistically significant decrease in pain scores for both the laser and the ultrasound groups when compared to the control group. Moreover, the laser and ultrasound group showed no difference between them in terms of reducing the pain scores.

Hence, it can be concluded that LLLT and the LIPUS may effectively reduce the separation pain experienced during orthodontic treatment after the application of multiple doses, without any difference between them.

R21/Matrix-M vaccine well-tolerated and efficacious against malaria in children, Vaccines, Docvidya, Medshorts, malaria, R21/Matrix-M vaccine

R21/Matrix-M vaccine well-tolerated and efficacious against malaria in children

A recent study found that R21/Matrix-M vaccine which is low-cost, was well tolerated and offered high efficacy against clinical malaria in children. The results of this study were published in the journal, Lancet.

This double-blind, randomised, phase 3 trial of the R21/Matrix-M malaria vaccine screened 5477 children (aged 5-36 months), out of which 1705 and 3434 children were randomly assigned in a 2:1 ratio to the control vaccine and R21/Matrix-M (5 μg R21 plus 50 μg Matrix-M), respectively. The vaccines were administered 4 weeks apart as 3 doses, with a booster dose administered 12 months after the third dose. Half of the participants were recruited at the seasonal malaria transmission sites and the other half at standard sites with perennial malaria transmission. The primary objective of the study was to assess the protective efficacy of R21/Matrix-M, 14 days following the third vaccination. Vaccine efficacy, safety, and immunogenicity were also assessed.

At the end of the study, it was found that R21/Matrix-M vaccine was well tolerated. The most frequent adverse events were injection site pain (301 out of 1615 participants) and fever (754 out of 1615 participants). At the end of 12 months, the vaccine efficacy at the seasonal sites and standard sites were 75% and 67%, respectively. The effectiveness of the vaccine was correlated with antibodies produced by the vaccination against the conserved central Asn-Ala-Asn-Pro (NANP) repeat sequence of the circumsporozoite protein. The 5-17 month age group of children showed higher NANP-specific antibody titres when compared to the 18-36 month age group.

From the above results, it can be concluded that R21/Matrix-M vaccine which is low-cost, may be well tolerated and may offer high efficacy against clinical malaria in children.